Longitudinal cohort study reveals stratified social gaze reductions in autistic children, highlighting the necessity of subgroup profiling for clinical biomarker utility.
Key Points
To determine how biological sex and cognitive ability moderate reductions in social attention over time in autistic children compared to neurotypical peers.
Longitudinal cohort investigation evaluating autistic and neurotypical children (aged 6–11 years) from the Autism Biomarkers Consortium for Clinical Trials across four timepoints: baseline, 6 weeks, 6 months, and 4 years.
Social attention was quantified using the oculomotor index of gaze to human faces (OMI) measured through standardized eye-tracking assays, with stratification by sex and IQ (cutoff of 85).
Linear mixed-effects models analyzed OMI longitudinal stability and its associations with clinical measures, including face memory and adaptive behavior.
Autistic females displayed roughly twice the reduction in OMI relative to sex-matched neurotypical controls compared to the reduction observed in autistic males, despite raw OMI scores being similar between autistic males and females.
The reduction in OMI relative to neurotypical peers was substantially larger in autistic children with below-average IQ (< 85) than in those with average or above-average IQ (≥ 85).
Gaze patterns remained stable over the 4-year follow-up, with OMI associating more strongly with face memory and adaptive behavior in autistic males and children with average-to-high IQ.